Culture stops women from delivering in hospital

During my recent tour of duty, I held informal discussions with colleagues looking for research topics on maternal and neonatal health. It emerged that there are still many factors hindering women from delivering in hospitals.

This is despite the fact that maternity services at most hospitals are now free. In Nyanza and Western, for instance, poverty, cultural practices and shortage of primary healthcare services are forcing women to seek the help of untrained traditional birth attendants, despite the serious risks involved.

My interviews revealed something interesting about the placenta. Traditionally, the placenta and the afterbirth are considered sacred and if mishandled, could lead to poor survival of the infant. Some consider it the permanent twin and companion of the infant.

Placenta mystery

Although some traditional and cultural beliefs have been overtaken by modernity, burying of the placenta remains an undying tradition in the region.

Most mothers worry that when they deliver in hospital, they will not get the placenta to bury in a secret location to ensure the infant "thrives".

When I worked in the region in my earlier days, I remember interacting with researchers who were collecting placentas to study malaria and HIV transmissions. They told me many women were worried and started demanding to be given their placentas back to carry home, even though this was regarded as biological waste by the hospital.

It took the intervention of community elders, after lengthy deliberations, to allow the study to proceed. To an extent, this may have affected the number of women willing to deliver in hospitals.

More research is needed to understand and explain the concerns about the placenta and afterbirth. A compromise would be necessary to allay fears, increase hospital deliveries, reduce maternal and neonatal complications and death during childbirth.